journal article·2025-01-23Open access

Guided Tissue Regeneration Membranes: Review of Innovations and Applications in Immunocompromised Patients

Man Hung, Katherine Sanders, Aditya Deshpande, Roshni Trivedi, Connor Schwartz, Amir Mohajeri

Applied Sciences· Volume 15· Issue 3

Abstract

Guided tissue regeneration (GTR) membranes are pivotal in regenerative medicine. While their effectiveness is established in general populations, their application in immunocompromised patients, such as those with diabetes or cancer, remains underexplored. This review evaluated evidence on GTR membranes in immunocompromised settings, focusing on their mechanisms, outcomes, and challenges posed by systemic conditions. A systematic search identified studies on GTR use in these populations. Inclusion criteria were peer-reviewed articles in English on human samples or relevant preclinical models. Of 218 articles, 5 met the criteria. These highlighted advancements in GTR technologies, such as stem cell integration, growth factor-enriched scaffolds, and scaffold-free tissue engineering. Stem cell-based approaches improved regeneration, especially with biomimetic designs incorporating bone morphogenetic protein-2. Innovations like microcavity-rich scaffolds enhanced angiogenesis and osteogenesis, while scaffold-free constructs minimized immunogenicity and supported functional tissue regeneration. Preclinical models demonstrated GTR membranes’ potential for addressing large-scale tissue deficits in compromised environments. GTR membranes show promise for immunocompromised patients, but further research is needed to validate their clinical efficacy, address patient-specific challenges, and evaluate long-term outcomes. These technologies could transform regenerative medicine, providing sustainable solutions for high-risk populations.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Mesenchymal stem cell research · Periodontal Regeneration and Treatments · Electrospun Nanofibers in Biomedical Applications

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA

Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT 84108, USA

Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA

Library, Roseman University of Health Sciences, South Jordan, UT 84095, USA

References (65)

Show source-provided references
1. Fort Collins (2024, December 05). Key Benefits of Guided Tissue Regeneration. Available online: https://www.fortcollinsperio.com/benefits-of-guided-tissue-regeneration.
2. Wang, D., Zhou, X., Cao, H., Zhang, H., Wang, D., Guo, J., and Wang, J. (2023). Barrier membranes for periodontal guided bone regeneration: A potential therapeutic strategy. Front. Mater., 10.10.3389/fmats.2023.1220420 ↗
3. Biomembrane-Based Nanostructure- and Microstructure-Loaded Hydrogels for Promoting Chronic Wound Healing10.2147/IJN.S387382 ↗
4. Resorbable Membranes for Guided Bone Regeneration: Critical Features, Potentials, and Limitations10.1021/acsmaterialsau.3c00013 ↗
5. Huang, T.-H., Chen, J.-Y., Suo, W.-H., Shao, W.-R., Huang, C.-Y., Li, M.-T., Li, Y.-Y., Li, Y.-H., Liang, E.-L., and Chen, Y.-H. (2024). Unlocking the Future of Periodontal Regeneration: An Interdisciplinary Approach to Tissue Engineering and Advanced Therapeutics. Biomedicines, 12.10.3390/biomedicines12051090 ↗
6. Tissue engineering: A new vista in periodontal regeneration10.4103/0972-124X.92564 ↗
7. Impact of diabetes mellitus on oncological outcomes after radical hysterectomy for early stage cervical cancer10.3802/jgo.2016.27.e28 ↗
8. Burgess, J.L., Wyant, W.A., Abujamra, B.A., Kirsner, R.S., and Jozic, I. (2021). Diabetic Wound-Healing Science. Medicina, 57.10.3390/medicina57101072 ↗
9. Buranasin, P., Mizutani, K., Iwasaki, K., Mahasarakham, C.P.N., Kido, D., Takeda, K., and Izumi, Y. (2018). High glucose-induced oxidative stress impairs proliferation and migration of human gingival fibroblasts. PLoS ONE, 13.10.1371/journal.pone.0201855 ↗
10. Yadav, J.P., Verma, A., Pathak, P., Dwivedi, A.R., Singh, A.K., Kumar, P., Khalilullah, H., Jaremko, M., Emwas, A.-H., and Patel, D.K. (2024). Phytoconstituents as modulators of NF-κB signalling: Investigating therapeutic potential for diabetic wound healing. Biomed. Pharmacother., 177.10.1016/j.biopha.2024.117058 ↗
11. Macrophage-mediated inflammation in diabetic wound repair10.1016/j.semcdb.2021.06.013 ↗
12. Wound healing complications in oncological patients: Perspectives for cellular therapy10.5114/ada.2018.72585 ↗
13. Chemotherapy-Mediated Complications of Wound Healing: An Understudied Side Effect10.1089/wound.2023.0097 ↗
14. Kolimi, P., Narala, S., Nyavanandi, D., Youssef, A.A.A., and Dudhipala, N. (2022). Innovative Treatment Strategies to Accelerate Wound Healing: Trajectory and Recent Advancements. Cells, 11.10.3390/cells11152439 ↗
15. Recent advances in GTR scaffolds10.6026/973206300181181 ↗
16. Bone Morphogenetic Protein-2 and Vascular Endothelial Growth Factor in Bone Tissue Regeneration: New Insight and Perspectives10.1111/os.12112 ↗
17. Recent progress in materials development and biological properties of GTR membranes for periodontal regeneration10.1111/cbdd.13959 ↗
18. Bruna, T., Maldonado-Bravo, F., Jara, P., and Caro, N. (2021). Silver Nanoparticles and Their Antibacterial Applications. Int. J. Mol. Sci., 22.10.3390/ijms22137202 ↗
19. The use of irradiated-crosslinked human collagen membrane in guided tissue regeneration10.1111/j.1600-051X.1992.tb01160.x ↗
20. Solomon, S.-M., Sufaru, I.-G., Teslaru, S., Ghiciuc, C., and Stafie, C. (2022). Finding the Perfect Membrane: Current Knowledge on Barrier Membranes in Regenerative Procedures: A Descriptive Review. Appl. Sci., 12.10.3390/app12031042 ↗
21. Choi, J.F., and Chang, P. (2024). Oral Surgery, Extraction of Unerupted Teeth, StatPearls Publishing.
22. International Diabetes Federation (2024, December 05). Facts & Figures. Available online: https://idf.org/about-diabetes/diabetes-facts-figures/.
23. International Agency for Research on Cancer (2024, December 05). Latest Global Cancer Data: Cancer Burden Rises to 19.3 Million New Cases and 10.0 Million Cancer Deaths in 2020. Available online: https://www.iarc.who.int/news-events/latest-global-cancer-data-cancer-burden-rises-to-19-3-million-new-cases-and-10-0-million-cancer-deaths-in-2020/.
24. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries10.3322/caac.21660 ↗
25. Barrier membranes for tissue regeneration in dentistry
26. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews10.1136/bmj.n71 ↗
27. Sphere-Derived Multipotent Progenitor Cells Obtained From Human Oral Mucosa Are Enriched in Neural Crest Cells10.5966/sctm.2015-0111 ↗
28. Dental pulp stem cells in chitosan/gelatin scaffolds for enhanced orofacial bone regeneration10.1016/j.dental.2018.11.025 ↗
29. Human tissue-engineered colon forms from postnatal progenitor cells: An in vivo murine model10.2217/rme.12.91 ↗
30. Basu, A., Rothermund, K., Ahmed, M.N., and Syed-Picard, F.N. (2019). Self-Assembly of an Organized Cementum-Periodontal Ligament-Like Complex Using Scaffold-Free Tissue Engineering. Front. Physiol., 10.10.3389/fphys.2019.00422 ↗
31. Graziano, A., d’Aquino, R., Angelis, M.G.C.-D., Laino, G., Piattelli, A., Pacifici, M., De Rosa, A., and Papaccio, G. (2007). Concave pit-containing scaffold surfaces improve stem cell-derived osteoblast performance and lead to significant bone tissue formation. PLoS ONE, 2.10.1371/journal.pone.0000496 ↗
32. Application of dental pulp stem cells in oral maxillofacial tissue engineering10.7150/ijms.68494 ↗
33. The recent advances in scaffolds for integrated periodontal regeneration
34. Alqahtani, A.M. (2023). Guided Tissue and Bone Regeneration Membranes: A Review of Biomaterials and Techniques for Periodontal Treatments. Polymers, 15.10.3390/polym15163355 ↗
35. Application of mesenchymal stem/stromal cells in periodontal regeneration: Opportunities and challenges10.1016/j.jdsr.2024.01.001 ↗
36. Angjelova, A., Jovanova, E., Polizzi, A., Annunziata, M., Laganà, L., Santonocito, S., and Isola, G. (2024). Insights and Advancements in Periodontal Tissue Engineering and Bone Regeneration. Medicina, 60.10.3390/medicina60050773 ↗
37. Mesenchymal stem cells derived from dental tissues vs. those from other sources: Their biology and role in regenerative medicine10.1177/0022034509340867 ↗
38. Velikic, G., Maric, D.M., Maric, D.L., Supic, G., Puletic, M., Dulic, O., and Vojvodic, D. (2024). Harnessing the Stem Cell Niche in Regenerative Medicine: Innovative Avenue to Combat Neurodegenerative Diseases. Int. J. Mol. Sci., 25.10.3390/ijms25020993 ↗
39. Halloran, D., Durbano, H.W., and Nohe, A. (2020). Bone Morphogenetic Protein-2 in Development and Bone Homeostasis. J. Dev. Biol., 8.10.3390/jdb8030019 ↗
40. Chu, D.-T., Nguyen, T.T., Tien, N.L.B., Tran, D.-K., Jeong, J.-H., Anh, P.G., Thanh, V.V., Truong, D.T., and Dinh, T.C. (2020). Recent Progress of Stem Cell Therapy in Cancer Treatment: Molecular Mechanisms and Potential Applications. Cells, 9.10.3390/cells9030563 ↗
41. Latimer, J.M., Maekawa, S., Yao, Y., Wu, D.T., Chen, M., and Giannobile, W.V. (2021). Regenerative Medicine Technologies to Treat Dental, Oral, and Craniofacial Defects. Front. Bioeng. Biotechnol., 9.10.3389/fbioe.2021.704048 ↗
42. Advancements in hydrogel design for articular cartilage regeneration: A comprehensive review
43. Asymmetric resorbable-based dental barrier membrane for periodontal guided tissue regeneration and guided bone regeneration: A review10.1002/jbm.b.35060 ↗
44. Zhu, L., Liu, Y., Wang, A., Zhu, Z., Li, Y., Zhu, C., Che, Z., Liu, T., Liu, H., and Huang, L. (2022). Application of BMP in Bone Tissue Engineering. Front. Bioeng. Biotechnol., 10.10.3389/fbioe.2022.810880 ↗
45. Chitosan alchemy: Transforming tissue engineering and wound healing10.1039/D4RA01594K ↗
46. Khanna, A., Zamani, M., and Huang, N.F. (2021). Extracellular Matrix-Based Biomaterials for Cardiovascular Tissue Engineering. J. Cardiovasc. Dev. Dis., 8.10.3390/jcdd8110137 ↗
47. Scaffold-free cell-based tissue engineering therapies: Advances, shortfalls and forecast10.1038/s41536-021-00133-3 ↗
48. Mariani, E., Lisignoli, G., Borzì, R.M., and Pulsatelli, L. (2019). Biomaterials: Foreign Bodies or Tuners for the Immune Response?. Int. J. Mol. Sci., 20.10.3390/ijms20030636 ↗
49. Regenerative medicine: Current therapies and future directions10.1073/pnas.1508520112 ↗
50. Scaffolding in tissue engineering: General approaches and tissue-specific considerations10.1007/s00586-008-0745-3 ↗
51. Guided tissue regeneration for the treatment of periodontal intrabony and furcation defects. A systematic review10.1902/annals.2003.8.1.266 ↗
52. Dental Biomaterial Scaffolds in Tooth Tissue Engineering: A Review10.1007/s40496-023-00329-0 ↗
53. Schilrreff, P., and Alexiev, U. (2022). Chronic Inflammation in Non-Healing Skin Wounds and Promising Natural Bioactive Compounds Treatment. Int. J. Mol. Sci., 23.10.3390/ijms23094928 ↗
54. Inflammatory responses and inflammation-associated diseases in organs10.18632/oncotarget.23208 ↗
55. Chen, Y., Zhou, Y., Lin, J., and Zhang, S. (2022). Challenges to Improve Bone Healing Under Diabetic Conditions. Front. Endocrinol., 13.10.3389/fendo.2022.861878 ↗
56. BMP-functionalised coatings to promote osteogenesis for orthopaedic implants10.3390/ijms150610150 ↗
57. Gao, Y., Wang, S., Shi, B., Wang, Y., Chen, Y., Wang, X., Lee, E.-S., and Jiang, H.-B. (2022). Advances in Modification Methods Based on Biodegradable Membranes in Guided Bone/Tissue Regeneration: A Review. Polymers, 14.10.3390/polym14050871 ↗
58. Cell-Inspired Biomaterials for Modulating Inflammation10.1089/ten.teb.2020.0276 ↗
59. Anjum, S., Rahman, F., Pandey, P., Arya, D.K., Alam, M., Rajinikanth, P.S., and Ao, Q. (2022). Electrospun Biomimetic Nanofibrous Scaffolds: A Promising Prospect for Bone Tissue Engineering and Regenerative Medicine. Int. J. Mol. Sci., 23.10.3390/ijms23169206 ↗
60. Inflammation and cancer10.1038/nature01322 ↗
61. Diban, F., Di Lodovico, S., Di Fermo, P., D’Ercole, S., D’Arcangelo, S., Di Giulio, M., and Cellini, L. (2023). Biofilms in Chronic Wound Infections: Innovative Antimicrobial Approaches Using the In Vitro Lubbock Chronic Wound Biofilm Model. Int. J. Mol. Sci., 24.10.3390/ijms24021004 ↗
62. Emergence of Scaffold-free Approaches for Tissue Engineering Musculoskeletal Cartilages10.1007/s10439-014-1161-y ↗
63. Liu, J., Ruan, J., Weir, M.D., Ren, K., Schneider, A., Wang, P., Oates, T.W., Chang, X., and Xu, H.H.K. (2019). Periodontal Bone-Ligament-Cementum Regeneration via Scaffolds and Stem Cells. Cells, 8.10.3390/cells8060537 ↗
64. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, and Forum on Regenerative Medicine (2024). Emerging Technologies and Innovation in Manufacturing Regenerative Medicine Therapies: Proceedings of a Workshop—In Brief, National Academies Press (US).
65. Yang, Z., Wu, C., Shi, H., Luo, X., Sun, H., Wang, Q., and Zhang, D. (2022). Advances in Barrier Membranes for Guided Bone Regeneration Techniques. Front. Bioeng. Biotechnol., 10.10.3389/fbioe.2022.921576 ↗